卵巢印戒细胞间质瘤的临床病理分析

Clinicopathologic Analysis of Signet-ring Stromal Tumor of the Ovary

  • 摘要: 目的 :探讨卵巢印戒细胞间质瘤(signet-ring stromal tumor,SRST)的临床病理特点、鉴别诊断、治疗、生物学行为及预后。 方法 :采用HE、组织化学和免疫组织化学SP法检测SRST肿瘤细胞PAS-D、CK、CK7、CK20、Vi-mentin、Actin、inhibin、calretinin的表达。 结果 :4例SRST患者年龄20~56岁(平均40岁),所有肿瘤均为单侧发生。组织学表现为印戒样细胞与梭形细胞混合存在,无上皮分化(如腺管、细胞巢或条索)。组织化学染色PAS-D、免疫组织化学染色CK、CK7、CK20、inhibin、calretinin均为阴性,Vimentin和Actin阳性。患者随访11~52个月(平均27.8个月),均生存,无肿瘤复发或转移。 结论 :SRST是少见的卵巢良性肿瘤,预后好,组织学上与Krukenberg瘤等肿瘤易混淆,结合临床病理特征、组织化学和免疫组织化学有助于SRST的诊断。

     

    Abstract: Objective :To investigate the clinicopathologic characteristics of signet-ring stromaltumors (SRST) and its differential diagnosis, therapy, biologic behavior and prognosis. Methods :Theexpression of PAS-D, CK, CK7, CK20, Vimentin, Actin, inhibin and calretinin in the SRST cells wasevaluated by H&E, histochemical and immunohistochemical staining. Results :The age of patients withSRST ranged from 20 to 56 years (mean age 40.0 years). All SRSTs were unilateral. The characteristichistological features were that the signet-ring cells were associated with spindle cells without epithelialdifferentiation (e.g. glands, nests or cords). The cells of SRST were negative for PAS-D by histochemi-cal staining and negative for CK, CK7, CK20, inhibin and calretinin by immunohistochemical staining,but they were positive for Vimentin and Actin. All patients with SRST were alive without metastasisand/or recurrence after 11-52 months (mean 27.8 months) of follow-up. Conclusion :Signet-ring stro-mal tumor is a rare, benign ovarian tumor with good prognosis and may be misdiagnosed as Krukenbergtumor according to histology alone. Clinicopathologic characteristics and features of histochemical andimmunohistochemical staining will be helpful in the diagnosis of SRST.

     

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